AARDA report examining current state of AD released at the National Autoimmune Diseases Summit

American Autoimmune Related Diseases Association (AARDA)Mar 4 2010

Milestone Report Addresses Increasing Prevalence, Skyrocketing Costs, New Treatments and Possible Causes of 100+ Diseases

A groundbreaking new report from the American Autoimmune Related Diseases Association (AARDA), examining the current state of autoimmune disease (AD) and its economic and social impact globally and in the U.S., was released today at the National Autoimmune Diseases Summit:  The Global State of Autoimmunity Today, held to kick-off National Autoimmune Disease Awareness Month.

Titled, "A Briefing Report on Autoimmune Disease and AARDA: Past, Present and Future," the comprehensive report presents an up-to-date assessment of all the most current data available on AD, including its incidence (frequency of disease development), prevalence (the number of people affected) and etiology (cause of AD).  The report also outlines current and pipeline treatment therapies, trends in research funding and the impact of AD on the U.S. health care system.  

This up-to-the-minute assessment is set against AARDA's own nearly 20-year history of raising awareness of autoimmunity as a category of diseases and a major U.S. health issue, and promoting a collaborative research effort in order to find better treatments and a cure for the more than 100 ADs.

"When AARDA was founded in 1992, there were roughly 67 known autoimmune diseases and another 20 strongly suspected of being autoimmune in nature.  Yet, the term 'autoimmune' was unheard of and a virtual void existed in terms of any type of national focus or understanding that these diseases constituted a significant disease category," said Virginia T. Ladd, Executive Director, AARDA.  "From the outset, AARDA's mission has been to fill that void and facilitate collaboration among national health agencies in the areas of autoimmune research, public education and patient services.  This new briefing paper is the latest manifestation of our mission."

Autoimmune disease disproportionately affects women.  Of the 50 million Americans living and coping with ADs, more than 75 percent are women.  AD is one of the top 10 leading causes of death of women under the age of 65.  It encompasses more than 100 diseases, including type-1 diabetes, multiple sclerosis, rheumatoid arthritis, Crohn's disease and lupus.  It is responsible for more than $100 billion in direct health care costs annually.  

Highlights from the first-of-its-kind report include:

Economic and Social Impact on U.S.

• While the National Institutes of Health have estimated the annual direct health care costs of AD in the U.S. to be in the range of $100 billion, according to the new assessment, that estimate might be too conservative, given that estimated annual direct and indirect costs for seven of the major ADs (Crohn's disease, ulcerative colitis, lupus, multiple sclerosis, rheumatoid arthritis, psoriasis and scleroderma) by themselves are $50 billion.
• Incidence and prevalence data for AD both in total and for individual diseases are either inconsistent or nonexistent.  Thus, there is a significant need to improve prevalence and incidence data gathering and reporting.  Several reports have indicated that autoimmune diseases collectively affect 5-10 percent of the developed world's population and are a significant cause of chronic illness and death.

Incidence and Prevalence

• "The Hygiene Hypothesis" -- Is being too clean a bad thing when it comes to autoimmune disease?  Yes, according to World Health Organization epidemiological data which indicate that ADs like type-1 diabetes and multiple sclerosis are extremely rare in most African and Asian populations, yet they increase conspicuously when these same populations migrate to a modern setting.
• "Environmental Triggers" -- After heredity and epigenetics, environmental triggers come next as a causative factor for autoimmune disease.  Beyond drug-induced AD, other suspected environmental triggers include infections, vaccines, female hormones, UVB radiation exposure, fetal blood cells, stress, vitamin-D deficiency and pollutants/toxins.

Current Therapies and Future Pipeline

• The vast majority of currently available therapies target only 10 or fewer of the 149 unique autoimmune or autoimmune-related diseases.  In addition, new drug development programs don't do much better.  They only target 30 percent of these diseases.
• Research programs that seek to find common mechanisms among groups of autoimmune diseases may provide a more reasonable and effective way forward.  Given that the drug development process takes roughly 7-10 years, and that the current pipeline lacks candidates for over 70 percent of the known autoimmune diseases, patients may have to wait at least a decade before seeing any progress.  
• Based on various reports, the global autoimmune therapeutics market is projected to reach between US $49 -69 billion by 2014.

The Way Forward

Looking to the future of AD diagnosis, management and research, the report calls for:

• increased awareness that AD runs in families and/or that there is a genetic pre-disposition;
• clinical training for physicians which emphasizes the nature and relationship of the various ADs;
• the creation of autoimmunologists who can provide a full perspective of AD, develop an overall patient management plan for specific diseases and refer patients to related specialists when needed;
• improved therapeutic interventions for the full spectrum of ADs, regardless of prevalence; and,
• the evaluation and identification of environmental autoimmune triggers so that susceptible individuals can avoid them and minimize or prevent the onset of an AD.